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Low-Dose Morphine for Dyspnea in Terminally Ill Patients with Idiopathic Interstitial Pneumonias
- Source :
- Journal of Palliative Medicine. 20:879-883
- Publication Year :
- 2017
- Publisher :
- Mary Ann Liebert Inc, 2017.
-
Abstract
- Dyspnea is highly prevalent in patients with idiopathic interstitial pneumonias (IIPs).The objective of this study is to examine the effectiveness and safety of continuous subcutaneous morphine for dyspnea in terminally ill IIP patients.We retrospectively reviewed cases of terminally ill IIP patients who received continuous subcutaneous morphine for dyspnea.We reviewed dyspnea severity measured using numerical rating scale (NRS) and respiratory rate (RR) before and two and four hours after morphine initiation. We conducted subgroup analyses of patients with and without noninvasive positive pressure ventilation (NPPV).Twenty-five patients were included in this study. Median morphine dose at morphine initiation and two and four hours after treatment was 0.25, 0.25, and 0.5 mg/hour, respectively. Dyspnea NRS decreased significantly four hours after (mean ± standard deviation: 5.32 ± 2.58, p = 0.04) but not two hours (5.52 ± 2.43, p = 0.11) after morphine initiation compared with baseline (7.08 ± 2.33). RR did not change significantly either two or four hours after treatment compared with baseline. The median survival after morphine initiation was 47 hours. Patients who were not using NPPV showed significantly improved dyspnea both two and four hours after treatment compared with baseline, although patients who used NPPV showed no significant improvement with morphine. RR did not significantly change in either subgroup.Morphine might improve dyspnea in terminally ill IIP patients without decrease in RR.
- Subjects :
- Male
Respiratory rate
Terminally ill
Infusions, Subcutaneous
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Terminally Ill
In patient
Idiopathic Interstitial Pneumonias
030212 general & internal medicine
Positive pressure ventilation
Idiopathic interstitial pneumonia
General Nursing
Aged
Retrospective Studies
Aged, 80 and over
Dose-Response Relationship, Drug
Morphine
business.industry
Low dose
General Medicine
Middle Aged
medicine.disease
Analgesics, Opioid
Dyspnea
Anesthesiology and Pain Medicine
030228 respiratory system
Anesthesia
Female
business
After treatment
medicine.drug
Subjects
Details
- ISSN :
- 15577740 and 10966218
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Journal of Palliative Medicine
- Accession number :
- edsair.doi.dedup.....2a6b6848da2024e567c40fe2aeed6310